Tag Archives: smoking

The Ironman Triathlon consists of a 2.4-mile swim, 112-mile bike ride and a 26.2-mile run. Surely, one might think, such a feat of athleticism would explode the joints of a human over, what, 40?

Not so, at least for the super-human. Mariana Phipps will be 71 this coming May. She’s a mom to three boys. Heck, she’s grandma to six children. Yet, she’s still a top competitor in one of the world’s most grueling test of human endurance.

Phipps was a swimmer as a girl, but couldn’t compete in high school or college in pre-Title IX days. By the time she started taking classes at Creighton University, it seemed that her serious days as an athlete were behind her.

“I was a pretty good, heavy smoker, and didn’t even think about doing any sports,” she says. “I had kids and I was busy.”

When her husband found out he had heart disease, they both quit smoking. However, she says, when you quit smoking, you need to do something else, “otherwise you blow up pretty fast.” She got back into swimming, and since many of her fellow swimmers were runners as well, she took up running and, later, bike riding.

Phipps ran her first marathon at age 51 in 1995 in Lincoln. She did her first Ironman at age 56 and qualified for the Ironman World Championship in Hawaii in her first year of qualifying. She routinely finishes in first or second place for her age group in triathlons and won the World Championship for her age group in Hawaii in 2005.

Kurt Beisch, who works as the race director for Race Omaha, a Nebraska non-profit organization in the multi-sport industry, says the World Championship in Hawaii is like the Super Bowl for triathlons.

Race Omaha puts on several annual racing events, including the Omaha Triathlon, the Omaha Women’s Triathlon, and the Omaha Kids Triathlon. The competitors, Beisch says, are definitely an eclectic bunch.

“They range from newbies, first-time multi-sport athletes, to very decorated nationally ranked athletes,” he says. The women’s triathlon field is made up of about 38 percent first-time athletes, which makes for a great amount of camaraderie.

Indeed, Phipps says, the triathlon competitors make the sport a very social one. This may seem a bit odd for an activity that, on its surface, seems to depend entirely on the individual’s stamina and endurance. But competitors feed off each other’s enthusiasm.

“We have a very good brotherhood of triathletes here in Omaha,” she says. “And I am fortunate enough to know a lot of younger ones and more mature ones.”

Beisch, who is also a decorated triathlete, estimates that about 15 percent of the participants in the field at the events are aged 50 or older, and some of them are some of the most accomplished athletes in the country.

“[They] make me look like a grade-school triathlete compared to the achievements they’ve had in the course of their lifetime,” he says.

Older competitors, he says, have an advantage in qualifying because there are fewer of them, so there’s less competition.

But more so than the competition, Beisch says, triathletes experience a great sense of accomplishment and that “coming across that finish line is an event.

“You have covered a lot of ground, you have pushed yourself in different ways and you have competed in three events,” he says.

Phipps has worked for Nebraska Furniture Mart for the last 39 years, and the company has been very flexible with her hours to allow her maximum training time. When getting ready for a triathlon, her weekly schedule involves two swims, two bike rides, and two runs. She trains 10-20 hours a week for an Ironman and may bike up to six hours a day (though shorter triathlons
don’t require as much training time).

She gives the impression of someone who really knows her stuff. In spite of the many jokes she makes about her age, there’s a quickness and vitality to her manner.

She’s also, it seems, just about unstoppable. She has a plate and several screws in each arm and a visible scar running down from her wrist. Before one event she broke her foot and couldn’t take painkillers because painkillers can cause kidney damage. She competed anyway.

This year, she plans on competing in the Boston Marathon for the sixth year in a row. In 2013, she was having a great race and was approximately four blocks from the finish line when the race was stopped and she was escorted to safety.

Later, she saw the local Boston media’s coverage of the bombing from her hotel room. “It was grotesque. Just blood everywhere. Obviously, people crying and moaning. It was just horrible.”

However, there wasn’t any hesitation about returning the next year.

“It wasn’t even a question about going back,” she says. “We weren’t about to let the enemy stop our dreams.”

So what keeps her going? Part of it, Phipps says, is that you compete against yourself.

“You can’t compare yourself to what you were 10 years ago, 20 years ago, 30 years ago,” she says. “Every time you enter a new age group you have to think it’s almost like a whole new ballgame.

“Luckily, they have age groups every five years. You think of yourself as trying to stay as fast as you can in that age group, and it’s the one thing that you look forward to getting older…because let’s face it, getting older is not fun. But, when you do go over that next hump, into the next age group, then you realize it’s a whole new set of personal records for your age. That helps a lot.”

With the implementation of Omaha’s indoor smoking ban in 2006, electronic cigarettes (e-cigs) have become a popular option for many patrons in local bars and businesses. Kiosks in the mall have started selling the so-called “better for you” cigarettes, and even Jake’s Cigars and Spirits in Benson and House of Loom in Downtown Omaha now sell and allow customers to smoke e-cigs.

Each bar has its own rules about e-cigs; it’s up to the owner’s discretion whether e-cig smoking in their establishment is allowed. Bar owner Tim Addison of Addy’s Bar and Grill in Millard says smoking e-cigs in his business is permissible, though he prefers those with e-cigs go outside “like everyone else.” Addy’s is a family-friendly place, he says, and he feels smoking e-cigs indoors just looks bad. Addison cites a regular customer who comes in often for lunch: “He smokes electronic cigarettes, but he still goes outside out of routine.”

The occasionally disposable but usually rechargeable e-cigs are a battery-powered nicotine delivery system that simulates the act of smoking a traditional cigarette. E-cigs use a mixture of vapor, flavoring, and nicotine to create a smoking affect, and some even have a light at the end that glows when inhaled, mimicking a real cigarette. The controversy surrounding e-cigs, however, is this: while makers claim they help some people quit smoking, they are still not considered a safe alternative to smoking by many health professionals. According to WebMD, e-cigs have different levels of nicotine, so in theory they can be used to lessen one’s addiction to cigarettes, or even help them quit. Unlike Chantix or the Nicotine patch, however, e-cigs are not FDA-approved as smoking cessation aids.

Marketers of e-cigs appeal to the smoking masses with brands like Njoy, Vapor4Life, and Blu Cigs (which is endorsed by actor Stephen Dorff). Blu Cigs offers flavored versions as well, like Magnificent Menth, Vivid Vanilla, and Pina Colada. Njoy even has a disposable version called One Joy. Despite their popularity, the jury is still out on the safety of e-cigs. But as Joy Fortuna from Pcmag.com writes, “E-cigs may help you decrease your dependence on nicotine…It is conceivable that a self-managed program of nicotine step-down might lead to a drug-free lifestyle.”

As far as bar owner Tim Addison is concerned, he plans to use e-cigs to help him kick his own smoking habit “real soon.”

The old saying “third time’s the charm” didn’t work so well for Laura Adams when it came to quitting smoking.

“Every time I quit, I’d be good for about six months,” she says. “Then I’d get stressed about something and decide to have just one. Well, once you start up again, it’s all over. It’s an all-or-nothing thing.”

Adams is not in the minority. Most smokers will try quitting multiple times before they are successful. There’s a lot more to smoking than meets the eye, say local smoking cessation experts. “There’s an addiction to nicotine, the actual habit, and the emotional dependence that all need to be addressed,” says Laura Krajicek, a smoking cessation coordinator for Nebraska Methodist Health System.

A smoker for more than 20 years, smoking had become a crutch for Adams. “It helped me deal with daily stresses,” she explains. “When I had a cigarette, that was my relaxation time, my ‘me time.’ Coffee, cigarettes, and break time all went together. It was hard to have one without the other.”

Adams knew that it wasn’t a “pretty habit,” nor one she was proud of. With a campus-wide no smoking policy at her place of employment, Alegent Creighton Health Immanuel Medical Center, Adams would have to “sneak” to an off-site parking lot to smoke. To mask the nasty smoke odor, she would slip on a different coat, pull her hair back in a ponytail, wash her hands, and coat herself with body spray before returning to the office. “It was an embarrassing addiction,” she recalls.

“When I had a cigarette, that was my relaxation time, my ‘me time.’” – Laura Adams, former smoker

When Adams learned about Alegent Creighton Health’s smoking cessation program, Tobacco Free U, she decided this might be the extra push she needed to help her quit for good. The program focuses on the use of group or individual counseling in combination with a smoking cessation aid such as nicotine patches, nicotine gum, or medications.

According to the Cochrane Review, an internationally recognized reviewer of health care and research, combining counseling and medication improves quit rates by as much as 70 to 100 percent compared to minimal intervention or no treatment.

“Success rates rise drastically when you combine the two,” says Lisa Fuchs, a certified tobacco treatment specialist at Alegent Creighton Health. The counseling portion helps people tackle the behavioral addiction, and the smoking cessation aids help with the nicotine addiction.

Which smoking cessation aid is recommended depends on how heavy a smoker, health conditions, as well as what seems to be the best fit for that person’s lifestyle, notes Fuchs. These aids are most successful in individuals who have been counseled on how to use them appropriately. The most common aids include:

Nicotine patch – The patch is a long-acting therapy that delivers a steady dose of nicotine over a 24-hour period and is designed to curb a person’s cravings for nicotine. This may be appropriate for very heavy smokers. The dosage is gradually lowered to wean a person off the nicotine habit.

Nicotine gum or lozenges – Gum and lozenges are short-acting therapies that deliver smaller doses of nicotine and can be taken as needed to curb the nicotine urge. Tom Klingemann, certified tobacco treatment specialist at The Nebraska Medical Center, recommends that smokers schedule the doses so that they maintain a steady state of nicotine in the body to avoid the nicotine cravings and temptation to smoke. In general, he is opposed to short-acting nicotine replacement therapies because “they keep people looking for a chemical fix even though they may not be smoking anymore.” They are also very expensive, and most people trying to quit can’t afford the $40 a week price tag they would cost if used appropriately.

e-cigarettes – These work by heating up a liquid nicotine substance that is inhaled as vapor. The product is not regulated by the Food and Drug Administration (FDA) and many still have a lot of chemicals that may not be any healthier than actual smoking, notes Klingemann. “These are not intended to help people quit but keep them addicted to nicotine,” he says.

Medications – The two primary prescription medications used for smoking cessation include Zyban and Chantix, with Chantix being the preferred of the two, says Fuchs. “Zyban is an anti-depressant and may be recommended for a person with mild depression to help with moodiness as well as decreasing cravings and withdrawals,” notes Fuchs. It is believed to work by enhancing your mood and decreasing agitation related to trying to quit.

Chantix is a newer drug and works by binding to nicotine receptors in the brain and blocking them so that nicotine can no longer activate those receptors, causing a person to get less satisfaction from smoking. At the same time, it also triggers a small release of dopamine, the reward neurotransmitter in the brain. It appears to be safe and quite effective, notes Klingemann. Krijicek says that her clients have seen the most success with this aid.

Adams used Chantix, which she said helped curb her nicotine urges. But what helped the most, she says, was to change the habits that she associated with smoking. For instance, instead of coffee and cigarettes in the morning, she reached for coffee and orange juice. Because she normally smoked while driving, she changed the route she drove to work. She also replaced the time she would have spent smoking with more positive habits like walking her dogs, running, bicycling, and swimming.

“Once I quit, I started making healthier decisions in other parts of my life as well,” she says. “I started eating better, drinking less caffeine, and exercising more. I feel better now.”

“For 90 percent of smokers, the addiction is behavioral,” notes Klingemann. “It’s all of the other stuff that drives the smoking addiction. Until you start changing your behaviors and routines, it’s really hard to quit.”

As a young woman of just 38 years old, Dionne Whitfield didn’t fit the typical description of a heart disease patient. But there she was, standing in front of the cardiologist, still tired and breathless after undergoing a treadmill test, trying to grasp the news that she had three major blockages.

She didn’t hear much after that. All she could think about was that she didn’t want to become a mere statistic. That she still wanted to have a family and live to see her potential children grow up. What was going to happen to her, she thought.

One week later, in August of 2012, Whitfield was back in the hospital undergoing triple bypass surgery. Today, Whitfield is doing great, and with age on her side, she is determined to take control of her health and her life again.

Looking back, she knows now that her unhealthy lifestyle habits were bound to catch up with her eventually. At 352 pounds, she ate whatever she wanted, often grabbing fast food along the way. She rarely exercised, and she had settled for the fact that she was overweight and nothing was going to change that. She was also African-American, a population that tends to have greater prevalence of risk factors for heart disease than Caucasian women.

“This has been a big eye-opening experience for me, and I don’t want to go back.” – Dionne Whitfield, heart disease patient

Whitfield’s attitude about her weight and health has done an about-face since then. Her attitude actually started to change with several warning signs shortly before the news of her blockages. In early January of last year, she learned that she was borderline diabetic. Concerned, Whitfield began attending group exercise classes and the pounds began to fall off. Motivated by her success, she began to make exercise a priority.

Then came her second warning. In July, she started becoming so short of breath that she could barely make the short walk from her office to the car. When things didn’t get better, she consulted with her doctor, who referred her to cardiologist Edmund Fiksinkski, M.D., at Nebraska Methodist Hospital, who performed the cardiac testing in which the blockages were found.

Whitfield’s surgery was performed by John Batter, M.D., cardiothoracic surgeon at Nebraska Methodist Hospital. After surgery, she underwent six weeks of supervised cardiac rehabilitation. Whitfield exercises on her own now but is still considered in a recovery phase for the next year and follows a moderate exercise program while her arteries heal.

“Dionne has done great,” says Susana Harrington, a nurse practitioner at Nebraska Methodist Hospital, who worked with Dionne throughout her recovery. “She really owned it and became more determined than ever to lead a healthy lifestyle.”

“This has been a big eye-opening experience for me, and I don’t want to go back,” says Whitfield. She continues to work out regularly, watches what she eats, and even reads labels now before putting food in her grocery basket.

She has also lost more than 72 pounds and is determined to double that. “I feel so much better now,” says Whitfield. “I’m not breathless now, and exercising is getting easier.”

“She really owned it and became more determined than ever to lead a healthy lifestyle.” – Susana Harrington, nurse practitioner at Nebraska Methodist Hospital

What women need to learn from this is that the development of cardiovascular disease is a lifelong process and that prevention is a lifelong effort, says Amy Arouni, M.D., cardiologist at Alegent Creighton Health. Controlling your risk factors very early in life can help prevent the development of heart disease later. This includes quitting smoking if you smoke, maintaining a healthy weight, exercising regularly, eating a diet low in saturated fats with lots of fruits and vegetables, and watching your blood pressure and cholesterol. In fact, women can lower their heart disease risk by as much as 82 percent just by leading a healthy lifestyle, according to the National Institutes of Health.

Prevention is important because heart disease is the No. 1 killer of all women, claiming the lives of approximately a half million women each year.

The main difference between men and women is that women are more likely to develop heart disease in their 60s and 70s, about 10 years later in life than men.

That’s because after menopause, risk factors tend to rise in women, especially blood pressure and cholesterol levels and rates of obesity, says Eugenia Raichlin, M.D., cardiologist at The Nebraska Medical Center. Other risk factors such as smoking, diabetes, and family history also raise a woman’s risk.

The consequences of heart disease also tend to be more severe in women. For instance, “a greater number of women die of sudden cardiac death before their arrival at a hospital (52 percent) compared to 42 percent of men,” says Dr. Raichlin. “Women often require more hospitalizations compared to men, have lower ratings of general well-being, and limitations in their abilities to perform activities of daily living. As a result, heart disease in women presents a unique and difficult challenge for physicians.”

In addition to prevention, women should also be aware of the symptoms of heart disease and the subtle changes in their bodies, says Dr. Arouni. “Unlike men, women’s symptoms tend to be more vague and atypical and may include mild neck, shoulder, upper back, or abdominal discomfort; shortness of breath; nausea or vomiting; sweating; lightheadedness or dizziness; extreme fatigue and/or a jaw ache that travels down the neck,” she says. “Because the symptoms tend to be vague, oftentimes, women will stay at home and ride it out.”

This is one of the key areas where women go wrong. “Getting help quickly is critical,” says Dr. Arouni. “The longer you wait, the greater the potential to suffer significant damage to the heart.”

While the development of heart disease in a woman’s 30s is less common, it does happen, especially when other risk factors are involved such as family history, obesity, or diabetes.

Whitfield feels fortunate that she and her doctors took her symptoms seriously and that she sought help early on. Now, she hopes she can help other women avoid the same fate by taking control of their health at a young age. “I feel very grateful to my family and friends and to the doctors and nurses that helped me get through this,” she says. “When you’re young, you don’t think anything can happen to you, but now I know differently. I don’t take my health for granted anymore.”